Incidence of tuberculosis among HIV-positive persons in the Czech Republic between 2000 and 2020
Authors:
J. Wallenfels 1; M. Malý 2
Authors‘ workplace:
Národní jednotka dohledu nad tuberkulózou, Fakultní nemocnice Bulovka, Praha
1; Oddělení biostatistiky, Státní zdravotní ústav, Praha
2
Published in:
Epidemiol. Mikrobiol. Imunol. 71, 2022, č. 2, s. 93-101
Category:
Original Papers
Overview
Aim: The aim is to characterize in more detail the group of HIV-positive persons in the Czech Republic diagnosed with tuberculosis (TB) in 2000–2020.
Material and methods: Data sources were mainly the national online TB register (RTBC), which is part of the information system of the Public Health Service, and the national electronic register of HIV-positive persons (RHIV) maintained by the National Reference Laboratory for HIV/AIDS of the National Institute of Public Health.
Results: Of 3,763 TB cases reported to the RHIV since 1985 and 16,212 TB cases reported to the RTBC since 2000, 91 occurred in 88 HIV-positive persons (69 males and 22 females) between 2000 and 2020. Sixty-five (74%) of the 88 HIV-positive persons were foreign born. Twenty-six per cent of TB cases were screened for HIV. The mean age of patients with TB/HIV coinfection was 35 years. The largest number of coinfected persons (35 cases) were from the capital city of Prague. Pulmonary TB was detected in 84 cases. Ninety-two per cent of the TB cases were bacteriologically confirmed, and 10 cases were multidrug-resistant TB. At the time of TB diagnosis, the median CD4+ lymphocyte count was 91.5 cells per mm3 of blood. TB was the most common reason for HIV testing in the analysed cohort (23 cases). The most common mode of HIV transmission was sexual intercourse (heterosexual in 39 cases and homosexual in 13 cases). Treatment success at 12-month follow-up was only recorded in 32% of cases of culture-positive pulmonary TB in HIV-positive patients.
Conclusions: TB/HIV co-infection remains a serious health concern, especially in the foreign-born residents of the Czech Republic. Of foreign-born persons with TB, 42% were tested for HIV over the 21-year study period, with their percentage increasing over the years. Almost 6% of them tested HIV positive. The most relevant finding is that treatment success was only recorded for less than one third of HIV-positive persons with culture-positive pulmonary TB and that every fourth patient with TB/HIV died before or during TB treatment.
Keywords:
AIDS – tuberculosis – HIV – Czech Republic – treatment outcome
Sources
1. Global tuberculosis report 2020. Geneva: World Health Organization; 2020. Licence: CC BY-NC-SA 3.0 IGO.
2. ÚZIS ČR. Základní přehled epidemiologické situace ve výskytu tuberkulózy v České republice v roce 2019 [cit. 2021-04-22]. Dostupné na www: <https://www.uzis.cz/res/f/008314/tbc2019-cz.pdf>.
3. WHO Tuberculosis data [cit. 2021-04-22]. Dostupné na www: <https://www.who.int/teams/global-tuberculosis-programme/data>.
4. Malý M, Němeček V, Zákoucká H. Výskyt a šíření HIV/AIDS v ČR v roce 2019. Zprávy CEM (SZÚ, Praha), 2020;29(10):384–398.
5. Wallenfels J, Malý M, Marešová M. Výskyt tuberkulózy u HIV pozitivních v České republice. Vakcinologie, 2009;3:134–139.
6. MZ ČR. Registr tuberkulózy. Metodika sběru a vyplňování vstupních dat pro hlášení tuberkulózy. Věstník MZ ČR, částka 1/2021.
7. European Centre for Disease Prevention and Control, WHO Regional Office for Europe. Tuberculosis surveillance and monitoring in Europe 2021–2019 data. Copenhagen: WHO Regional Office for Europe; 2021.
8. Tavares AM, Fronteira I, Couto I, et al. HIV and tuberculosis co-infection among migrants in Europe: A systematic review on the prevalence, incidence and mortality. PLoS ONE, 2017; 12(9):e0185526.
9. Ellis PK, Martin WJ, Dodd PJ. CD4 count and tuberculosis risk in HIV-positive adults not on ART: a systematic review and meta- analysis. PeerJ, 2017; 5:e4165.
10. van der Werf MJ, Ködmön C, Zucs P, et al. Tuberculosis and HIV coinfection in Europe: looking at one reality from two angles. AIDS, 2016;30:2845–2853.
11. Karo B, Krause G, Hollo V, et al. Impact of HIV infection on treatment outcome of tuberculosis in Europe. AIDS, 2016;30:1089–1098.
12. WHO operational handbook on tuberculosis. Module 1: prevention – tuberculosis preventive treatment. Geneva: World Health Organization; 2020. Licence: CC BY-NC-SA 3.0 IGO.
Labels
Hygiene and epidemiology Medical virology Clinical microbiologyArticle was published in
Epidemiology, Microbiology, Immunology
2022 Issue 2
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